Rate of hospital deaths for pneumonia and COPD drops after Covid-19 vaccine roll-out - report

The rate of hospital mortality for pneumonia and chronic obstructive pulmonary disease (COPD) decreased following the Covid-19 vaccine roll-out, a new report shows.

The National Office of Clinical Audit (Noca) published its seventh report from the National Audit of Hospital Mortality (Nahm) on Tuesday, which analysed data on mortality in hospitals in 2021.

The data showed the crude mortality rate for stroke conditions and Acute Myocardial Infarction (AMI) has declined over the last 10 years.

The crude mortality rate is defined as the number of deaths occurring during the year, per 1,000 population, estimated at midyear.

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However, while crude mortality for stroke conditions and AMI declined, heart failure mortality has risen in 2021, and the reasons why are “not yet evident,” said the report.

Crude in-hospital mortality for heart failure increased by 15 per cent between 2020 and 2021, from 63 deaths per 1,000 admissions in 2020, to 73 deaths per 1,000 admissions in 2021.

The crude mortality rate for COPD and pneumonia rose in early 2021, which could be linked to Covid-19, the report said. It showed a slight increase from 38 deaths per 1,000 admissions in 2020, to 41 deaths per 1,000 admissions in the first half of 2021.

However it decreased in late 2021 and early 2022 following the vaccination and booster roll-outs.

Pneumonia crude mortality saw a statistically significant increase from 103 deaths per 1,000 admissions reported in 2019 to 140 deaths per 1,000 admissions reported in the first half of 2021.

Crude in-hospital mortality for AMI has declined steadily from 69 deaths per 1,000 admissions in 2012, to 48 deaths per 1,000 admissions in 2021.

[ Increase in pneumonia deaths in 2020 linked to Covid-19 ]

Among other key findings was a significant reduction (42 per cent) in crude in-hospital mortality for ischemic stroke from 116 deaths per 1,000 admissions in 2012, to 68 deaths per 1,000 admissions in 2021.

For Hemorrhagic stroke there was a 21 per cent reduction in crude in-hospital mortality from 309 deaths per 1,000 admissions in 2012, to 253 deaths per 1,000 admissions in 2021.

The report presented mortality rates for six medical conditions, using data from 44 publicly funded hospitals in Ireland, with 31 hospitals meeting the criteria for inclusion in the report.

All hospitals were within “expected ranges,” despite the high numbers of Covid-19 cases in the reporting period.

The report cannot be used to compare hospitals to one another as “no two hospitals are expected to be the same, as hospitals have very different case mix or patient profiles,” the report said.

Anne Dee, NAHM clinical lead said she was “reassured to see that NAHM have continued to improve the quality of our healthcare systems through their work”.

“NAHM continues to strive for transparency and improvements in mortality outcomes for in-patients. This report and future reports will be essential to monitor in-hospital mortality in Ireland,” she said.